Community leaders, mental health advocates and others long had identified the need for a mental health sub-acute facility in our community. The Crisis Assessment and Treatment Center opened in the Summer of 2011 and serves individuals experiencing a mental health crisis who cannot manage their symptoms on their own and do not need a hospital stay to become stable. The Board of County Commissioners adopted a resolution in July 2009 to develop a facility to provide sub-acute mental health services. The board agreed to dedicate funds to the CATC by signing a Memorandum of Understanding (MOU) on June 17, 2010 between Multnomah County and the City of Portland.

The Crisis Assessment and Treatment Center is a 16-bed secure, locked facility in which people can stay from four to 14 days as their mental health symptoms stabilize.

Upon discharge, each person will have a plan for follow up treatment in the community.

Staff also helps find other resources necessary for each person to remain stable, such as housing, basic needs assistance and care for physical health needs.

The center is designed as an inviting, safe and supportive environment for recovery from crises.

The staff includes peers who provide support, advocacy and mentoring.

The center is located on the second floor of the David P. Hooper Sobering Center, located at 30 NE MLK Blvd., which is owned by Central City Concern – a local non-profit organization that specializes in addiction recovery, housing and mental health treatment. Design changes were necessary to make the second floor appropriate for use as the Crisis Assessment and Treatment Center.

County officials worked with the City of Portland, the State of Oregon and other local stakeholders to come up with ways to pay for the center.

Multnomah County’s 24-hour, seven-day-a-week Mental Health Call Center (at 503-988-4888) manages admission to the center. Call Center staff work with the police and local hospitals to triage individuals to the most clinically-appropriate place in our crisis continuum. This might include a mental health walk-in clinic, a hospital or sub-acute services.

Who can be seen at the Crisis Assessment and Treatment Center?

The Crisis Assessment and Treatment Center treats individuals in our community who are experiencing a mental health crisis but who are not appropriate for inpatient hospitalization. The Mental Health Call Center at 503-988-4888 will determine whether an individual needs the services of the Crisis Assessment and Treatment Center or would benefit from another type of service.

What is a mental health crisis?

A mental health crisis usually means that the symptoms of a person’s illness have gotten significantly worse. The person is so ill that he or she might hurt him/herself or another person as a result of the worsening symptoms. The person’s symptoms are significantly interfering with his or her ability to function at normal levels. He or she needs care immediately to stabilize safely so they can return to treatment in the community.

Can you give examples of when someone might be appropriate for the Crisis Assessment and Treatment Center?

The center is appropriate when an individual needs crisis stabilization in a secure setting and is too ill to go to crisis respite, but not so ill that he or she needs hospitalization.

Scenario one: Person A has depression and his symptoms have recently gotten much worse. His symptoms are severe enough that they are interfering with his ability to function. He talks about suicide and might have a history of hurting himself but does not currently have a plan for how to carry out a suicide.

Scenario two: Person B is a client at a mental health provider agency but recently has not been participating in treatment. Her psychosis symptoms have increased and she has been hearing voices more often. She is still able to process information but is having increased difficulty functioning as her symptoms escalate.

In each of these and other scenarios, the Mental Health Call Center likely will be the first point of contact – either for the public, police agencies or anyone else who encounters someone in crisis.

How do the police use this facility?

The police contact the Mental Health Call Center on a dedicated line if they encounter someone who appears to be in crisis due to symptoms of a mental illness. They may also contact Project Respond mobile crisis outreach. The Mental Health Call Center then manages admission to the facility. County mental health specialists assist the police in getting people in crisis access to care, whether it be at the urgent walk-in clinic, emergency room or the center.

Who else is able to refer a person to the Crisis Assessment and Treatment Center?

When providers from mental health agencies have someone they believe is ill enough to need care in the Crisis Assessment and Treatment Center, they will contact the Mental Health Call Center. Staff will work with providers to assess the person’s need and manage admission to the Crisis Assessment and Treatment Center if it is an appropriate place for him or her to go.

What happens when a person is stable enough to leave?

When someone is ready to be discharged from the Crisis Assessment and Treatment Center, staff will make sure that he or she is linked with community resources to help prevent another crisis. This can include things like connecting the person to a mental health provider agency, housing resources or a primary health care provider. When someone new to the mental health system is ready to be discharged, staff ensure that the individual has an appointment with the provider agency of his or her choice for after-care. Staff also try to connect people with natural supports such as informal caregivers, family and friends.

Does this replace other community crisis programs?

No. This is an important addition to the existing crisis structure already in place in our community. The Crisis Assessment and Treatment Center works in harmony with the other crisis programs, such as the Mental Health Call Center, Urgent Walk-in Clinic and Project Respond mobile crisis outreach team.

The Call Center serves as the information and referral hub of the county’s mental health and addictions system. Call Center employees also serve as a wing of the county’s crisis response system by responding to calls from the public about people in crisis. The Urgent Walk-in Clinic provides crisis care for consumers who need to be seen right away. Project Respond is the county’s immediate responder for situations involving people who are in crisis. The team also works with police and other emergency responders who have interactions with mental health consumers needing immediate help.

How is the building and operating of the Crisis Assessment and Treatment Center paid for? Does it take funding from existing crisis programs?

We do not take money from any other part of the crisis system to pay for the Crisis Assessment and Treatment Center. The Portland Development Commission committed $2 million for development and the State of Oregon contributed $1 million for capital costs of renovating the building for this new purpose. Insurance reimbursement, including Medicaid, funds some of the ongoing operation costs.

Is this the same as the Crisis Triage Center (CTC) that was a part of Providence years ago?

No. The Crisis Assessment and Treatment Center has a limited capacity of 16 beds and cannot function as a triage center where anyone who wants services can show up. The police, emergency room staff or another part of the crisis system all will be able to request that a person be admitted to the Crisis Assessment and Treatment Center. They will do this by calling the Mental Health Call Center at 503-988-4888. The police also may call on a phone line dedicated for their use. The Mental Health Call Center staff person will determine whether the needs of the person can be met at the Crisis Assessment and Treatment Center and if the facility has room. If the person needs a different level of care to be safe, the Call Center staff will work with the other parts of the crisis system to ensure that he/she gets the right help.

How can I get involved or give my input?

You, as a citizen of Multnomah County, are an important partner in developing the public health structures upon which we all rely. We hope to encourage your participation by holding community meetings, giving you the opportunity to submit questions via email, posting regular updates to the county website as new information is available, and through ongoing committees.

How will the advisory committee work with the other Mental Health and Addiction Services Division advisory committees?

We have liaisons from the advisory committee attend the other committee meetings that serve to advise the Mental Health and Addiction Services Division, such as the Adult Mental Health and Substance Abuse Advisory Council (AMHSAAC). If attending other Department of County Human Services or county committees seems appropriate or helpful, the Crisis Assessment and Treatment Center advisory board will consider sending a liaison.

Can consumers be included in the staff?

Yes. Peer support specialists will be a part of the staff of the Crisis Assessment and Treatment Center, as they are in other sub-acute programs across the nation. Peer support specialists also will be included on the advisory committee.

Is there medical staff at the Crisis Assessment and Treatment Center?

Yes. Medical and mental health professionals are on the staff of the Crisis Assessment and Treatment Center. Medical staff perform the evaluation and medical clearance necessary for admission and provide other basic medical services as they are needed.

Is this a secure facility?

Yes. It is our responsibility to keep the people in our care safe. We also believe that it is important to move people into the least restrictive treatment setting as soon as it is safe to do so. Crisis Assessment and Treatment Center staff make sure each person has a discharge plan that includes a community treatment provider.